Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 325650 | LA |
NPI | 1508285545 |
---|---|
Provider Name | Maria Christine Carratola |
First Address | Baton Rouge, LA 70836-6455 |
Second Address | Baton Rouge, LA 70836-6455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 30/03/2021 |